@layout("/common/_form.html",{js:["/assets/btyEkb/btyEkb_add.js"],css:["/assets/expand/module/formSelects/formSelects-v4.css"]}){

<form class="layui-form" id="btyEkbForm" lay-filter="btyEkbForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">标题<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="title" name="title" placeholder="请输入标题" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">备注<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="remark" name="remark" placeholder="请输入备注" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">部门<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="bm" name="bm" placeholder="请输入部门" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">状态<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="state" name="state" placeholder="请输入状态" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">报销总金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="sumAmount" name="sumAmount" placeholder="请输入报销总金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">核销总金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="writeOffAmount" name="writeOffAmount" placeholder="请输入核销总金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">报销日期<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="expenseDate" name="expenseDate" placeholder="请输入报销日期" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">付款人<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="fkr" name="fkr" placeholder="请输入付款人" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">银行卡号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yhk" name="yhk" placeholder="请输入银行卡号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">所属银行<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="bank" name="bank" placeholder="请输入所属银行" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">所属支行名称<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="zhmc" name="zhmc" placeholder="请输入所属支行名称" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">创建日期<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yyr" name="yyr" placeholder="请输入创建日期" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">报销人<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="bxr" name="bxr" placeholder="请输入报销人" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">行号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="hh" name="hh" placeholder="请输入行号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">0未打款 1已打款<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="flag" name="flag" placeholder="请输入0未打款 1已打款" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">易快报id<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="ekbId" name="ekbId" placeholder="请输入易快报id" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">节点id<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="nodeId" name="nodeId" placeholder="请输入节点id" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">创建时间<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="cjsj" name="cjsj" placeholder="请输入创建时间" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">单号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="code" name="code" placeholder="请输入单号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">支付日期<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="zfrq" name="zfrq" placeholder="请输入支付日期" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}